What's Inside: Your 2023 product training recap | Introducing two new pharmacy networks: Community First Network and The Market Network | Time for a dental premium holiday | Member-submitted medical claim form enhancements | A new Capital Blue Cross Connect health and wellness center in York | Save $20 with Fitness Your Way
Your 2023 product training recap
Thank you to all who attended the 2023 product training sessions that were held last week. If you missed it or need a refresh, we got you covered! Check out the recording and/or visit the presentation deck.
The network will be available to Large Group Custom ASO, with quoting starting on October 3, 2022, for effective dates on or after January 1, 2023.
In 2024, we plan to expand Community First Network to include these additional market segments: Large Group Custom Fully Insured, Large Group Standard (PremierChoice), Mid-Market Fully Insured, Small Business ASO, and Small Group PPACA.
The Market Network This tiered network option offers lower member cost-sharing at preferred pharmacies, plus ample access to other highly-used pharmacies. The Market Network includes two in-network tiers:
Preferred tier — Lowest member cost share when members use preferred pharmacies, including nearly 8,100 independent pharmacies.
Nonpreferred tier — Higher member cost share; includes the approximately 55,000 pharmacies in our Broad network.
The Market Network is available now to Large Custom ASO groups. Starting October 3, 2022, it will be open for quoting to Large Custom Fully Insured (FI), Small Business ASO, Mid Market FI, and PremierChoice, with effective dates on or after January 1, 2023.
Check out our pharmacy networks flyer for details on what all four of our networks have to offer employer groups and members — including options for value-added solutions, such as 90-day fill options and home delivery services.
Time for a dental premium holiday
Capital Blue Cross has a special offer for new groups who sign up for medical and dental coverage, or for existing medical groups that add Capital Blue Cross Dental. Please note that existing medical groups need to add dental on cycle with their renewal to qualify. Those groups will receive a holiday of one month’s dental plan premium when enrolling in dental coverage, and another when renewing that coverage. That means two months of no dental premium for the group, as a thank you from us!
When groups qualify for the holiday, a one-month credit to their dental premium/admin fee will be applied 75 to 90 days after the start of the contract. When the group renews, another one-month credit will occur 75 to 90 days later.
Member-submitted medical claim form enhancements
We've reimagined the claim form that Capital Blue Cross members submit for out-of-network medical claims, making it simpler and easier to understand. The redesigned form is now an interactive PDF.
Members should use the form to request payment or reimbursement if they received medical services or supplies under the medical plan from an out-of-network provider. The process for sending the form and accompanying provider bill by mail has not changed. Detailed instructions are included on the form.
A new Capital Blue Cross Connect health and wellness center in York
A new Capital Blue Cross Connecthealth and wellness center is now open at WellSpan’s Apple Hill Medical Center in York. Like our other centers, the one in York offers members and nonmembers alike benefit plan consultations and health and wellness screenings. Producers, employers, and community organizations are welcome to use our space for meetings and events.
This is the second Capital Blue Cross Connect health and wellness center located at a WellSpan facility, expanding our joint commitment to accessible, consumer-focused healthcare.
Save $20 with Fitness Your Way
Members can pay just $19 a month for the first two months of membership when they enroll in Blue 365's Fitness Your Way program by September 30.
Not a gym rat? That's alright! Fitness Your Way now offers digital-only packages as well.
Capital Blue Cross has adopted a team approach to support you, as we collaborate to enhance business relationships, foster your growth through education and incentives, and actively support the communities we serve. The Producer Relations team thanks you for your commitment and hard work. Reach out whenever you need them.